FDA Adverse Event Injury Summary report: N

MEDACTA KNEE IMPLANTS

MDR report key: 5396333 · Received January 28, 2016

Report

Report Number
3005180920-2016-00004
Event Type
Injury
Date Received
January 28, 2016
Date of Event
December 29, 2015
Report Date
April 18, 2016
Manufacturer
MEDACTA INTERNATIONAL SA
Product Code
JWH
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
CA, US
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

THE SURGEON SUBMITTED A REPORT THROUGH MEDACTA WEBSITE WITHOUT ANY INFORMATION ON THE IMPLANT; HE ONLY MENTIONED MYKNEE (K093806) THAT IS AN INSTRUMENT USED DURING THAT CASE. UP TO (B)(6) 2016 WE WERE NOT ABLE TO GET MORE INFORMATION FROM HIM, EVEN IF THERE WERE MULTIPLE ATTEMPTS TO DO IT.

Additional Manufacturer Narrative · 1

ON 22 MARCH 2016 IT WAS PREPARED A FINAL REPORT WITH THE INFORMATION ALREADY SUBMITTED IN THE INTIAL REPORT. ON 23 MARCH 2016 THE REPORT WAS SENT TO THE INITIAL REPORTER AND THE CASE WAS CLOSED.

Description of Event or Problem · 1

THE PATIENT WENT TO THE SURGEON WITH TIBIAL SUBLUXES POSTERIORLY DURING FLEXION.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
53635 MEDACTA KNEE IMPLANTS TOTAL KNEE IMPLANT JWH MEDACTA INTERNATIONAL SA

Patients

Seq Age Sex Outcome Treatment
1 81 YR Other